目的 調查汶川地震災區中學生腸易激綜合征（IBS）的患病情況，分析羅馬Ⅱ和羅馬Ⅲ診斷標準對該人群IBS患病率的影響。 方法 在汶川地震后2年半和3年，分別用羅馬Ⅱ和羅馬Ⅲ標準制定IBS中學生問卷調查表對地震災區和非地震災區5所中學的中學生進行2次調查，分析比較IBS患病率的變化。 結果 用羅馬Ⅱ標準調查發現地震災區中學生IBS患病率為23.6%；非地震災區患病率為21.6%，二者比較無統計學意義（P=0.267）；用羅馬Ⅲ標準調查發現地震災區中學生IBS患病率為6.2%，非地震災區患病率為4.6%，二者比較無統計學意義（P=0.139）。符合兩種診斷標準的地震災區IBS學生有10.3%，非地震災區IBS學生有9.2%，兩者差異無統計學意義（P＞0.05）。②支持兩種診斷標準的癥狀方面，地震災區IBS學生每天排便＞3次或每周排便＜3次等癥狀相比較有統計學意義（P＜0.001）。③按羅馬Ⅲ標準，各亞型構成比IBS-C為30.4%，IBS-D為28.4%，IBS-M為8.8%，IBS-U為32.4%；按羅馬Ⅱ標準，各亞型構成比為IBS-C為28.5%，IBS-D為47.7%，腹瀉和便秘交替型為18.6%，羅馬Ⅲ標準中的IBS-M和IBS-U合為一組與羅馬Ⅱ標準中的腹瀉和便秘交替型的構成比進行比較，二者有統計學意義（P＜0.001）。 結論 羅馬Ⅱ和羅馬Ⅲ兩種標準調查地震災區中學生IBS患病率和分型存在著差異，但兩種標準對地震災區IBS患病率的影響是對等的，患病率和分型的不同是由兩種標準的本身的差異造成，可能更接近羅馬Ⅲ診斷標準。
Objective To investigate the diagnostic value of esophageal high-resolution manometry combined with salivary pepsin levels in laryngopharyngeal reflux disease (LPRD). Methods The patients with the chief complaint of “throat discomfort” for treatment at the Department of Otolaryngology, Head and Neck Surgery, the First People’s Hospital of Longquanyi District, Chengdu / West China Longquan Hospital Sichuan University between January and October 2022 was selected. According to the reflux findings score and refluxsymptomindex at admission, the enrolled patients were divided into LPRD group and non-LPRD group. The basic patient information, esophageal high resolution manometry, and salivary pepsin concentration of included patients were collected. Results A total of 112 patients were included. Among them, there were 68 cases (60.7%) in the LPRD group and 44 cases (39.3%) in the non-LPRD group. The LPRD group was significantly younger (P=0.007) , but the salivary pepsin concentration (P<0.001), upper esophageal sphincter (UES) resting pressure (P<0.001) and distal contractile integral (P=0.007) were all higher than the non-LPRD group. The results of multivariate logistic regression analysis showed that salivary pepsin concentration [odds ratio (OR)=1.077, 95%CI (1.035, 1.120), P<0.001] and UES resting pressure [OR=1.035, 95%CI (1.019, 1.052), P<0.001] were independent factors for the diagnosis of LPRD. The area under the working curve (0.971), specificity (0.99), and sensitivity (0.77) in the combined index were higher than those of saliva pepsin concentration and UES resting pressure. Conclusion Esophageal high resolution manometry and salivary pepsin are significant for the diagnosis of LPRD, and their combined application can improve the diagnostic value and also serve as an alternative method for the diagnosis of LPRD.